Medical Authorizations Specialist

Sparrow Company LLC•El Paso, TX

13d•$0 - $15•Onsite

About The Position

Sparrow Company is searching for a detail-oriented and organized Medical Authorizations Specialist to support healthcare operations by obtaining and managing insurance authorizations for patient services. This role is ideal for someone with strong knowledge of insurance processes, excellent communication skills, and the ability to work efficiently in a fast-paced healthcare environment.

Requirements

High school diploma or GED required
Minimum of one (1) year of experience with insurance authorizations, referrals, or prior authorizations in a healthcare setting required
Experience verifying insurance eligibility and benefits required
Strong understanding of insurance plans, payer requirements, and authorization processes
Excellent written, verbal, and interpersonal communication skills
Strong organizational skills with exceptional attention to detail
Ability to prioritize multiple tasks and meet deadlines in a fast-paced environment
Ability to work independently and collaboratively as part of a healthcare team

Nice To Haves

Experience working with electronic health records (EHR) systems preferred
Knowledge of medical terminology preferred
Bilingual in English and Spanish preferred

Responsibilities

Obtain and process prior authorizations, referrals, and pre-certifications for medical procedures, diagnostic testing, specialty services, and treatments
Verify patient insurance eligibility, benefits, coverage requirements, and authorization needs
Review clinical documentation to ensure completeness and accuracy for authorization submissions
Communicate with insurance companies, healthcare providers, and patients regarding authorization status and requirements
Track and monitor authorization requests to ensure timely approvals and prevent delays in patient care
Follow up on pending, denied, or incomplete authorization requests and initiate appeals when appropriate
Document authorization activities, approvals, denials, and communications within the electronic health record (EHR) system
Maintain accurate patient demographic and insurance information
Educate patients regarding insurance requirements, authorization processes, and financial responsibilities as appropriate
Collaborate with physicians, clinical staff, scheduling teams, and insurance representatives to facilitate patient care
Identify and resolve authorization-related issues while maintaining a high level of customer service
Ensure compliance with HIPAA regulations and organizational confidentiality standards
Maintain knowledge of payer guidelines, insurance regulations, and authorization requirements
Participate in training and professional development activities to remain current with healthcare industry standards and best practices
Consistently meet departmental productivity, quality, and turnaround time goals
Adhere to all organizational policies, procedures, and practices
Perform all other duties as assigned